NC 67 primarily follows an east–west alignment and connects the towns of Jonesville, Boonville, and East Bend, along with the city of Winston-Salem.

The first NC 67 was established as an original North Carolina state highway in 1921 traversing a route between Taylorsville and Sparta.

Departing Jonesville, it primarily runs through rural Yadkin County until entering Boonville and picking up the name Main Street.

East of the intersection, NC 67 leaves Boonville near Kerr Drive and travels through a predominately rural region, composed of alternating farmland and forested area.

As the highway continues southeast, it gradually enters into a suburban residential area northwest of Winston-Salem.

A partial cloverleaf interchange provides access to Robinhood Road and Silas Creek Parkway begins a turn to the south.

The roadway then reaches an interchange with Bolton Street, turns to the east and re-enters a residential area of Winston-Salem.

Heading towards the Forsyth Tech campus, Silas Creek Parkway downgrades from a partial controlled-access highway to a boulevard with adjoining streets intersecting NC 67 at-grade.

[4][1] The North Carolina Department of Transportation (NCDOT) measures average daily traffic volumes along many of the roadways it maintains.

In 2015, average daily traffic volumes along NC 67 varied from 3,100 vehicles per day west of the intersection with Smithtown Road in Yadkin County to 55,000 vehicles per day along Silas Creek Parkway north of the Country Club Road interchange in Forsyth County.

[5][6][7] NC 67 is included within the National Highway System[a], along Silas Creek Parkway between Wake Forest Road and US 421.

The highway then travelled for approximately 30 miles (48 km) through East Bend and Bethania to end at US 421 and NC 60 (modern-day Old Yadkinville Rd) in Oldtown.

[21][22] The North Carolina State Highway Commission approved a bid by Harvey H. Stewart Company to replace the bridge across the Yadkin River in September 1950.

Instead it was routed to briefly follow Wake Forest Road and Silas Creek Parkway bypassing downtown Winston-Salem and ending at NC 150, its modern-day eastern terminus.

The interchange is planned to be located between Bethania and Tobaccoville, approximately where NC 67 currently intersects Roberts Road.

[33] The same segment of the Northern Beltway was also approved by the American Association of State Highway and Transportation Officials (AASHTO) in 2019 to become I-274 upon completion.